Benzodiazepines!

Question 1

Benzos popped up in the…

Answer 1

1950’s

Question 2

Benzos are used to treat: (5)

Answer 2

Anxiety
Alcohol withdrawal
Status epilepticus
Dystonias
Pre-anesthetic

Question 3

Benzos possess this quality, useful in status epilepticus

Answer 3

Anti-convulsant

Question 4

The anticonvulsant activity is RT

Answer 4

Ability of drug to inhibit cell firing by altering flow of CHLORIDE through cell membrane.

Question 5

Anxiolytic action believed to be RT enhancing effect of:

Answer 5

GABA in brain (GABA agonist)

Question 6

Preferable to barbs because:

Answer 6

Greater margin of safety
Less likely to interact w/ other drugs
Less likely to cause physical dependence than barbiturates

Question 7

T/F Benzodiazepine can cross the placenta and appear in breast milk.

Answer 7

TRUE

Question 8

Relatively safe group BUT

Answer 8

Big potential for tolerance, dependence & abuse

Question 9

Prototype for Benzos?

Answer 9

Diazepam! Valium. Mamas little helper.

Question 10

Specific benzos different from eachother in…

Answer 10

Pharmacokinetic profile

Question 11

All benzos are available…

Answer 11

PO

Question 12

T/F most benzos are rapidly absorbed.

Answer 12

TRUE

Question 13

Peak levels of benzos occur in..

Answer 13

1/2-6 hours

Question 14

Half lifes range (pretty big!) depending on drug

Answer 14

3-100 hours

Question 15

The drugs with longer have-lives have…

Answer 15

Active Metabolites

Question 16

T/F Benzos are highly protein bound.

Answer 16

TRUE

Question 17

Besides PO Benzos are available:

Answer 17

IM or IV

Question 18

Benzos typically produce ___ side effects.

Answer 18

CNS - drowsiness, dizziness, lethargy, slurred speech, weakness & ataxia

Question 19

Besides CNS side effects, benzos are frequently associated with these seemingly opposite effects

Answer 19

Dysphoria, irritability, agitation

Question 20

The most MAJOR side effect of benzos:

Answer 20

Dependence

Question 21

T/F Benzos have significant drug interactions.

Answer 21

FALSE - mainly other CNS depressants

Question 22

CNS interactions common with:

Answer 22

Alcohol
Phenothiazines
Cyclics
MAOI's 
Antihistamine

Question 23

5 benzos that don’t end with pam. (ACCMT)

Answer 23

alprazolam .75-3
clorazepate 15-60
chlordiazepoxide 15-100
midazolam ----
triazolam 0.125-0.5

Question 24

Chlordiazepoxide is the benzo of choice in treating:

Answer 24

Alcohol Withdrawal (aka Librium)

Question 25

The pams!! (CDFLOT)

Answer 25

clonazepam 8-10
diazepam 5-60
flurazepam 15-30
lorazepam 1-10
oxazepam 30-60
temazepam 15-30

Question 26

Of the pam’s this one should be given at bedtime:

Answer 26

flurazepam 15-30

Question 27

Of the non-pams this one is used as an anesthetic! Memory loss for duration

Answer 27

midazolam —

Question 28

This pam can cause a countereffect (agitation) in elderly

Answer 28

lorazepam 1-10

Question 29

Of the non-pams this one should also be given at bedtime:

Answer 29

triazolam 0.125-0.5

Question 30

Longest half life? (100 hour pam)

Answer 30

flurazepam 15-30

Question 31

Diazepam has a half life of?

Answer 31

90 hours (3 days)